D Magazine ⋅ Special Report Dallas Medical Directory 2009

Living with Adult ADD

Never before has our society been more focused on the issues surrounding attention disorders, which is great news for kids suffering from ADD or ADHD. But what if the adults are the ones with the problem?

Here’s how John Walker “studied” during his nine years of off-and-on college, according to a friend of his: He’d fix the lights. Balance the fan because it was making noise. Make sure the light from the window came in just right. Get a drink. Go to the bathroom.

“By the time I was finally calmed down enough to study, [my friend] was already done,” Walker remembers. “She said, ‘I think you have ADD.’ I probably dismissed it in an off-handed way, parroting back what my parents had told me—that ADD was just an excuse that lazy kids give when they don’t want to do their homework.”

The good news is children and teenagers dealing with attention disorders are on the radar. Never has our society been more focused on an issue that, just 20 years ago, was incredibly misunderstood by doctors, parents, teachers—just about everyone. The bad news is, about 5 percent of adults have attention deficit disorder (ADD) or its constantly moving cousin, attention deficit hyperactivity disorder (ADHD). For them, the learning curve is steep. They carry baggage from damaged self-esteem. Many suffer from depression as well as co-related brain issues such as dyslexia and Tourette syndrome. Adults with ADD are more likely to drop out of college, get fired from jobs, abuse drugs and alcohol, and divorce.

Walker, who lives in Dallas and whose name has been changed for this article, followed a fairly predictable path of someone who doesn’t deal with his ADD. He used alcohol and drugs—illegal and prescribed—to self-medicate. Jobs usually didn’t last more than a few years because they got boring or stressful, just like college did. Relationships were often unstable because of all of the above and the ADD brain’s need for stimulation, often in the form of drama.

“Everybody wants to feel normal,” he says of his drug and alcohol use. “Everyone wants a baseline.”

Like Walker, many ADD adults have tried self-medicating with alcohol and drugs. Some people call it an addictive personality; Dr. David Clark, a chiropractic neurologist in Dallas, sees it as a brain that does not have the machinery to keep an even keel.

“The vast majority of people who have these problems are prone to various types of addictions, be it illegal or otherwise,” Clark says. “Some people will use a stimulant, maybe just coffee or nicotine, and say they feel great. Their mind is clear. They’ll think, ‘I’m a great employee on this. I’m a great husband on this.’ Then they have to use it, and it has unintended side effects.”

The Diagnosis

Many adults realize they have attention issues when addressing the same problems with their children. In fact, this is the most common path to diagnosis for the adults Dr. Harvey Oshman sees. Suddenly, parents are looking at a list of symptoms and behaviors and they see themselves as much as they see their 7-year-old.

“It will be an ah-ha experience,” says Oshman, a Dallas psychologist who specializes in adult ADD. “They’ll say, ‘When I was a boy, I was just like that.’ The lightbulb goes on, and you find out there is treatment.”

At 26, Walker was diagnosed with ADD—a diagnosis he says was a huge relief. “Suddenly I’m not lazy, stupid, and undisciplined. ‘Discipline’ was a word I used to hate. It was a bar so high that I couldn’t reach it—but not from lack of trying.”

Ten years after his diagnosis, Walker hit a rough patch. Within a year’s span, Walker’s dad died, his marriage ended, and he found himself unemployed—again. He tried medication, but it made him unemotional. He does credit medication, though, with giving him a window into what the non-ADD brain feels like. The drugs and alcohol clearly weren’t compatible with a healthy life, so now he’s trying regular exercise, vitamins, a proper diet, regular sleep, and counseling from time to time.

Every adult deals—or doesn’t deal—with ADD in his or her own way. Many choose therapy and medication; some choose medication on its own, although it isn’t recommended. Some try alternative therapies that alter the brain the way medication can. Still others hire life coaches and join support groups. Many try a bit of everything.

The Support Group

Melissa Petty never goes to Wal-Mart on a Saturday. She laughs about it, but a weekend afternoon among the masses and smiling yellow faces can be incredibly stressful for someone with ADD.

“It’s overwhelming,” she says. “[There are] too many people and too many things. I gave myself permission and have never gone back. That one small thing has made my life infinitely better.”

Petty is a board member for the ADD Association - Southern Region, the last regular in-person support group for adult ADD in the Dallas-Fort Worth area. While Internet support groups have taken the place of these monthly gatherings, a group of 20 or so meets on the second Thursday of every month. Petty, a social worker, helped found the group 20 years ago when her son was diagnosed with ADHD. She was officially diagnosed 10 years ago. Just talking about your ADD—whether with a doctor, a support group, or a friend—is helpful, she says.

“I found out a great deal about myself—my weaknesses but also my strengths,” Petty says. “And it was comforting to know that my problems were not due to a lack of character or intelligence. The minute you understand that you’re ADD, whether you take any intervention, you will start making better decisions for yourself.”

The people who come to the group are a mix of those who deal with ADD using medication, therapy, or life coaching; Petty has tried all three. Some life coaches specialize in ADD clients, and she has found them to be incredibly helpful for the practicalities of life. She hired one to organize her office in an ADD-friendly way: by color. “I can’t remember if I filed banking under B for bank, C for cash, or F for finance,” she says. “So I put everything financial under green because it looks like cash. It’s very simple, but it was profound for me.”

Douglas Anderson, a retired pilot in Southlake, has been a life coach for three years. Because he has ADD himself, he has plenty of empathy for ADD adults, which make up about half of his clientele. “People with ADD are very predictable to a large degree,” says Anderson, a member of the International Coaching Federation. “It’s helpful to understand you’re just like everybody else, that you’re not a bad person.”

He starts with education and self-esteem building. He also has three recommendations for everyone with ADD: get some type of calendar, make a daily list, and create a vision board in a common area of your house. This can include calendar items as well as bigger concepts, like weight-loss goals or vacation plans. In addition, Anderson recommends using a worksheet to help with time awareness, filling out what you’re doing for each 30-minute block of your day. And he advises his clients to clean up their clutter—a common problem for people with ADD—and handle a piece of paper only once.

Although he’s never had a life coach, Walker has incorporated some of these tricks into his everyday life. He has become far more organized, and he performs many tasks in a routine and methodical way, including leaving his coat, wallet, keys, and phone in the same place every time.

As a good coach should, Anderson gives his clients some much-needed cheerleading as well as practical advice. “It’s an absolute fact that every person with ADD has some special gifts that they would not have if they didn’t have ADD,” he says. “Many times, these special gifts are dramatic, creative gifts, like a musical or artistic ability. But in most cases, these gifts are subtler, like empathy and intuition. If I learn to work with those, I can be very helpful in building their lives.”

The Treatment

Therapy for attention issues is very practical. According to Oshman, simple things make all the difference.

“When you have untreated ADD, you develop a lot of bad behavior habits and traits—procrastination, poor organization, poor time management, losing things, misplacing things,” Oshman says. “They’re always running behind, always feeling overwhelmed, always under stress. There is a whole set of behavior characteristics that flow from the inability to pay attention.” Oshman works with patients on essential life skills that ADD adults never developed.

In conjunction with therapy, many ADD sufferers try medication. ADD medications are called stimulants because the ADD brain is understimulated, although exactly where differs from person to person. The most common and newest medications for ADD on the market now are Adderall, Concerta, Focalin, Daytrana (which comes in a patch), and Vyvanse (which has to mix with acid in your gastrointestinal tract to work, meaning it can’t be abused by snorting or otherwise misusing it).

Drugs, however, are not for everyone, and some ADD adults are trying a relatively new idea—that the ADD brain can be changed. Permanently. Without drugs. Oshman doesn’t discount this approach, although it certainly isn’t the norm. “A lot of the treatment is educating people about the disorder, giving them very concrete coping skills,” he says.

Dr. David Clark agrees. But he wants to take it a step further. The ADD brain is different from the average brain. Everybody knows this. What everybody doesn’t know is the brain can be changed. Its pliable nature is what interests Clark.

By determining exactly which part of the brain isn’t working properly—and that differs in each individual—Clark creates exercises and tasks that stimulate that area. These exercises can include working with an Interactive Metronome, doing core-strength exercises, and listening to specific music—all of which stimulate certain areas of the brain. The understimulated part is what causes the symptoms of ADD, which is why stimulants are often the recommended treatment.

Last year Matt Salim spent hours taking the second part of his four-part chiropractic exams, something that would have been much more difficult, he says, without help from Clark. “I’ve always struggled paying attention in class,” says the 30-year-old Irving student, who didn’t realize he had ADD until he heard Clark speak at a neurology seminar in Dallas. He sought treatment from Clark for about seven months, doing eye exercises and working with the Interactive Metronome and wobbly board to strengthen the parts of his brain that were deficient.

Most adults 30 and up who come to Clark for help were not diagnosed with ADD as children. But he treats their brains just as he treats the brains of his younger patients because the areas affected are the same. He admits ADD can be more difficult to treat in adults because their brains aren’t as adaptable as a child’s. “A 45-year-old adult with attention issues has a brain that is way more used to it,” he says. “We’re trying to get the brain to break a really, really bad habit.”

Most adults don’t want anybody to know they’re getting treated. “There’s a real stigma with ADD,” Clark says. “With people who are younger, even in their teens and 20s, it’s more accepted. You get to your 30s and 40s, and people expect you to grow out of it. But what’s changed? Nothing’s changed. The brain imbalance is still there.”

Clark also admits that the toughest thing about treating adults is their own ADD. No one is watching an adult to make sure he keeps his appointments or does his exercises. “A lot of times, they sabotage their attempt to get treated,” Clark says. “They forget appointments or want instant gratification. It’s harder on adults unless they are extremely motivated.”

At age 40, Walker is motivated to keep the fairly stable life he has worked hard to create, a life that no longer includes alcohol or drugs. “If I’d known 10 years ago I could be as happy and sane as I am now, I never would’ve picked up the glass,” he says. “I thought I was helping, thought I was making things better.”

Where To Get Help for ADD

EXPLORING THE OPTIONS: The broad spectrum of complications from Adult ADD can present quite a challenge for people coping with the disorder. Most patients dealing with ADD find it’s more effective to incorporate a variety of therapies and treatments in order to get a handle on life with ADD. The following list is a snapshot of regional support for people living with ADD.